Yao Han, Samoukovic Gordan, Farias Emidio, Cimone Sam, Churchill-Smith Michael, Jayaraman Dev
Department of Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada.
Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Air Med J. 2019 Mar-Apr;38(2):106-114. doi: 10.1016/j.amj.2018.11.009. Epub 2019 Jan 16.
The air medical transportation industry has seen a steady rise in the use of mechanical circulatory support devices (eg, intra-aortic balloon pumps, ventricular assist devices, and extracorporeal membrane oxygenation) during transport missions, either for definitive management or repatriation. As these complex devices become more common, the industry will have to adapt to support their use in their clientele. The goal of this narrative review was to assess our current experiences regarding mechanical circulatory support devices in air medical transportation and to identify important factors to ensure successful transport.
We conducted a systematic search on MEDLINE and Embase using the following search terms: aeromedical transportation, air transportation, intra-aortic balloon pump, ventricular assist device, and extracorporeal membrane oxygenation. Results were cross-referenced to identify articles addressing both air medical transport and mechanical circulatory support devices.
After a systematic review of the available literature, 49 articles addressing mechanical support devices transported by rotary wing and fixed wing aircraft were reviewed. In summary, our review encompassed 811 total aerial transports (152 by balloon pumps, 12 by ventricular assist devices, and 647 by extracorporeal membrane oxygenation). We found air medical transportation with these devices carried out in the public, private, or military sectors, to be safe, with low rates of serious adverse events. Dedicated training sessions focused on device troubleshooting and problem-solving during transport, optimal medical crew composition, predeparture logistical preparations, and on-demand specialist consultation can improve mission success.
We report that air medical transportation of patients supported by mechanical circulatory support devices is safe. Complications can be mitigated by training and addressed either during the predeparture or in-transportation phase.
在转运任务中，无论是进行确定性治疗还是遣返，空中医疗运输行业使用机械循环支持设备（如主动脉内球囊泵、心室辅助装置和体外膜肺氧合）的情况一直在稳步上升。随着这些复杂设备变得越来越普遍，该行业将不得不做出调整，以支持在其客户中使用这些设备。本叙述性综述的目的是评估我们目前在空中医疗运输中使用机械循环支持设备的经验，并确定确保成功运输的重要因素。
我们在MEDLINE和Embase上进行了系统检索，使用了以下检索词：航空医疗运输、空中运输、主动脉内球囊泵、心室辅助装置和体外膜肺氧合。对结果进行交叉引用，以识别涉及空中医疗运输和机械循环支持设备的文章。
在对现有文献进行系统综述后，对49篇涉及由旋翼机和固定翼飞机运输的机械支持设备的文章进行了审查。总之，我们的综述涵盖了总共811次空中运输（152次使用球囊泵、12次使用心室辅助装置、647次使用体外膜肺氧合）。我们发现，使用这些设备的空中医疗运输在公共、私人或军事部门进行时是安全的，严重不良事件发生率较低。专注于运输期间设备故障排除和问题解决、最佳医护人员组成、出发前后勤准备以及按需专家咨询的专门培训课程可以提高任务成功率。
我们报告称，由机械循环支持设备支持的患者空中医疗运输是安全的。并发症可以通过培训得到缓解，并在出发前或运输阶段加以解决。
